Author: hjbarton

The power of an introduction

If you think about how we use language to interact with people, pronouns are fundamental. If I’m introducing you to my friend, I’m likely to say something like, “Hey! This is Madison—they’re a good friend of mine.” We use these introductory moments to create relatedness, yet, inadvertently, something about identity gets expressed. If we aren’t attentive to what we express about identity, we are liable to lean toward our ingrained assumptions about who and how people are. That’s not to say that the identity we construct for people when we introduce them is inherently true or inescapable—we discovered that in the forum—but regardless we are accountable for the world that gets created about people when we open our mouths.

The way I see it, there are three fundamental aspects to share or, alternatively, learn about someone in an introduction: the name the person would like to be called, how to pronounce that name, and what pronouns they use. Undoubtedly, there are other aspects that may be more applicable depending on the context, but as a base, what it is to know someone is to be able to refer to them as they would like to be referred to. 

2023 was a big year for me—it was the year I became a doctor. But let me clarify, no, not that kind of doctor. If I don’t insert myself quickly, I can find myself in way over my head. To be fair, I’m a smart cookie with a Biomedical Engineering degree, plenty of pre-med classes under my belt, and an above average MCAT score[i], but that doesn’t mean I can diagnose your rash.

What’s in a name?

For many people, their name may not be a particularly important part of their identity. Maybe their name connects them to their family because they were named after a relative or they’ve used different nicknames throughout their lives, but for the most part their name’s a given, because well, it was given. For many transgender and gender non-conforming people, the opposite is true—their name was chosen. Selected after many hours of researching names and testing them out in chat groups or with friends, their name was chosen by them.

I’ve never changed my name, but loved ones have. In the state of Wisconsin where I live, one must pay a $164.50 filing fee to file name change forms with the court, run an advertisement announcing the date of the name change hearing in the local newspaper, and attend a court hearing with a judge to change their legal name. It’s a burdensome process that somehow, every time I’ve borne witness to it, leaves people relieved. Relieved that their name is now recognized legally and the incongruence of living with a name that didn’t fit is gone. I can relate to that in terms of changing my pronouns.

During my PhD program, I looked forward to becoming a doctor so that I wouldn’t ever have to select between Ms., Mrs., or Mr. again (and for anyone who has done a doctorate, you know that it’s the little things that keep you going when it gets tough). Unfortunately, even with my doctorate there are places that force me to select between those limited options.[ii]

What’s in place of a name?

Pronouns are those “words we use instead of a noun to avoid repetition of it.”[iii] In the place of a name, they’re little words like I, we, she, they, or him. Like our names, our use of pronouns often goes unnoticed—until maybe someone uses the wrong pronoun for our pet or we hear a 3-year-old use “she” when referring to their brother. Typically, our use of personal pronouns is based on our perception of a person’s gender.[iv] For people whose outward expression of gender matches their sex assigned at birth and their internal experience of who they are, this perception might always be in alignment; however, for transgender or gender non-conforming folks this might not be the case.

I started using she/they pronouns in 2020. I can’t say exactly why, maybe because I could put it in my Zoom nametag and that felt low stakes enough. Or it may have started off as a nod to my queerness in an expression-constrained environment (Zoom)—the opportunity to say, “hey, I’m here and I’m probably not who you think I am.” Mostly no one used they/them pronouns to refer to me, but occasionally people would ask what it meant to have both “she” and “they” pronouns. Sometimes I would have that conversation with them.[v] I remember, once, recreating a Self Expression and Leadership Program[vi] classroom with a participant who called me out on that—“when you don’t know what you want me to call you, you just put that work on me when all I want to do is refer to you in a way that is comfortable for you.” I was taken aback but struck by the idea that I was making it harder for people to care for me.

It wasn’t until August of 2021 that I would start using they/them pronouns exclusively. I was deeply depressed at the time, grasping for ways to experience people’s care. For the first time, asking people to use they/them pronouns for me occurred as an invitation I could extend. I found I could invite people to meet me, newly.

Hi all, I’m Hanna Barton. I use they/them pronouns and am interested in a world where each of us is exquisitely cared for by community.

[i] The MCAT is the test you take to get into medical school. At one point I was applying for a joint MD/PhD program, eventually deciding to focus solely on the PhD—but not before I took the last in-person MCAT of 2020 on March 14th.

[ii] This is poor design that excludes people who do not use any of those prefixes.

[iii] https://www.etymonline.com/word/pronoun, accessed January 15, 2024

[iv] Judith Butler describes gender as a performance—something we learn how to perform “correctly” based on social scripts. See her 1990 book, Gender Trouble: Feminism and the Subversion of Identity.

[v] No one owes you an explanation for why they use the pronouns they use, nor do they owe you a “pronouns 101” lecture. It takes emotional work to educate around topics sensitive to one’s own identity, so my personal practice is to not ask people questions that I can google. If after my research I’m still curious about someone’s gender identity, I might ask them if they are open to a conversation about it; however, I will make it very clear that they do not owe me their time, explanation, or vulnerability.

[vi] The Self Expression and Leadership Program is a course offered as part of the Landmark Curriculum for Living. The conversation I am referring to happened during a program I head coached, where most of my interaction directly with participants was by way of “recreating” (re-capping) classrooms if they had missed them.

First published as a “Report from the Field” in The Journal of the 2024 Conference for Global Transformation.

A Note to self… Transformative Birth is Possible

Birth is a natural process.[1] Our bodies are capable of it.[2] Surrounded by people who believe this and support this notion allows us to know this for ourselves. Few things in life offer the profound opportunity of re-defining who you are and what you are capable of to the same degree. When pregnancy, labor, and childbirth are approached with reverence and power, each person who has the pleasure to be involved leaves transformed—be them the birthing person, the birth attendant, the spouse, or any other loved one.

The midwifery model situates itself in these very concepts. That most birth will proceed without need for intervention and that a birth attendant should center themselves on providing the birthing person with the environment (physical, spiritual, social, etc.) that best facilitates their comfort and empowerment.[3] The notable midwife, Ina May Gaskin, describes her “sphincter law” which governs labor and birth for many midwives in a congruous way. Sphincters, no matter where they are on our bodies, are shy, don’t open on command, and close quickly to perceived threat.[4] There is a reason that we have doors on bathrooms.

Furthermore, the midwifery model integrates a person’s mind and body. Ina tells stories of women whose labor was stalled until they spoke out loud and moved through their past traumas or fears, and alternatively women who have experienced rapid dilation through mantras or affirmations of their power, strength, courage, or capabilities.[5] The model acknowledges these facets of a person’s identity to be included and valued for the impact they have on their birth experience and outcomes. In this way, each contraction, or ‘rush,’ is to be experienced, rather than survived, endured, or ‘gotten through.’[6] It is about steadying confidence in the birthing person, since we know they are capable of having a safe, healthy, and even orgasmic birth.

Conversely, when birth is not revered for the transformational opportunity it is, it can be exploited in the name of ease or paternalistic notions of safety. The medical model of birth views childbirth as inherently risky, necessitating monitoring, supplementation, and intervention.[7] The Monty Python sketch “The Miracle of Birth” from The Meaning of Life pokes fun at the ways in which medicine and technology have removed providers from actually providing care and has left them with lots of technology that is not required for the vast majority of births.[8] The notion of a technocratic birth is troubling as it often leaves the birthing person (patient) as someone in need of curing, and as such, their experience as an afterthought. You can see how this is in stark contrast with the midwifery model’s emphasis on the birthing person’s comfort, safety, and empowerment.

Another hallmark of the medical model is that doctors take active, vigilant roles in delivering babies.[9] This is even seen by the position in which the majority of people give birth in the medical setting—lithotomy.[10] In the U.S. today it is common to not only be induced (given a form of synthetic oxytocin, Pitocin, to initiate or enhance contractions), but to consequently be given an epidural to cope with the very pains that were caused by induction.7 Furthermore, the numbing effect of the epidural then breaks the hormonal feedback loop that occurs naturally in the body, such that the need for forceps or vacuum interventions increases.[11] All the while, the risks and side effects for the birthing person are put aside in favor of an overarching narrative of “it’s best for the baby!” The medical model, however well intentioned, routinely denies people the birthing experience they want and ignores the birth experience that is possible free of anesthetics and in a curated, safe environment.

The medical model of birth so deeply holds the view that birth is dangerous that cesarean sections are frequently utilized when not necessary. Midwives have long held knowledge about how to deliver breech babies or turn babies in the womb.[12] However, currently, these techniques aren’t taught nor utilized by doctors. In the U.S. especially there are consistent incentives for doctors to resort to cesarean section, whether that’s for fear of litigation, convenience of scheduling, or inability to be with loud, powerful women.[13]

In Brazil, the rate of cesarean sections has reached as high as 70-99% for people who are privately insured, and 25-40% (still above most industrialized nations) for those publicly insured.[14] There are strong cultural beliefs that birth will deform or damage the vagina and/or labia making the genital area less attractive. The fear of lasting injury coupled with the fear of pain harkens back to the 19th century shadow of midwifery.[15] Yet, in this case, Brazilian women can choose to have a cesarean to effectively bypass the confrontation of all that fear. This is also juxtaposed to the squalid conditions that publicly insured Brazilians endure to give birth, further influencing people to choose cesarean as the ‘safer’ and easier choice.14 While there are many contributing factors that may be due to the Brazilian culture, some factors fit the state of the U.S. healthcare system as well. The fear of pain and belief that “if we can alleviate it, we should” are common in American birth narratives.[16]

Yet what’s more insidious about the cesarean statistics in Brazil and around the world is that, overwhelmingly, women claim to prefer vaginal birth.[17] Despite this preference, over the course of labor, the doctor’s interactions with the woman slowly influence the final decision to perform a cesarean section (once again) “for the baby’s sake.” The systemic drivers of high cesarean rates are largely the same as in the U.S., where Obstetrics is a surgical sub-specialty that churns out doctors highly capable of surgery and skeptical or even fearful of ‘organic’ or ‘natural’ childbirth.[18] Quite simply, Obstetricians are the experts on intervention, not on birth, which makes their likelihood of resorting to an intervention much higher.

There are other nations that more wholly integrate the roles of midwives alongside doctors. In Japan, both the midwifery and medical model are founded on a physiological view of birth. The doctor is seen as being able to use the tools necessary to step in if the birth becomes complicated, and, in contrast to the U.S., step back when the risky portion of the birth is over.[19] Despite the Obstetrician holding authority over birth, midwives deliver most children—a sign that while birth carries a potential for danger, it is not inherently risky. A glimpse into another nation’s model of care enlightens us of our own values and viewpoints on birth.

When choosing your birth setting, it’s important to take all of these things into account. Who will be present? What knowledge are they trained in?[20] What preconceived notions of birth do they bring to the table? Where will the birth take place? Who will have the say where I am? Or what position I am in? And in a larger context, after I give birth, who will I know myself as? Will I know myself as strong and powerful? Or left as if there is something wrong with me? In reality, it’s not so dichotomous—people’s experiences are not so clean cut. The midwifery and medical models blend in some settings, such as in birthing centers.[21] Yet, it is essential we question the systems we operate within—what is the true purpose of a health system and are we fulfilling on it?[22]

If the purpose is to provide people with optimal health, including mental well-being, it is clear the medical model of childbirth is not doing its job. If we continue to operate as we have in medical settings, we will continue to deny people the experiences they want, and often don’t even know they can have. Movements such as Unassisted Birth and Pain to Power have started to shift what is possible in childbirth, but there is more to do if we want to provide each person with all of their choices.[23][24] The charge to people who have had empowering, painless, orgasmic birth is to speak out, and to pregnant or soon-to-be pregnant people to question the way the system works. Be curious about what’s possible and what you’re capable of. Seek out people who will support your power and your nature. Transformative birth is possible.

[1] All mammals give birth. Humans are the only ones that resort to interventions such as forceps, anesthesia, episiotomy, and cesarean section.  

[2] Ina May Gaskin cites interventions in birth (cesarean or vacuum/forceps extraction) at The Farm at less than 1.5% of births up to 2000. Page xiii of Ina May Gaskin’s Ina May’s Guide to Childbirth, 2003.

[3] Lecture Notes: Technocratic Childbirth, Karen Walloch, September 11th, 2018.

[4] Page 170 of Ina May Gaskin’s Ina May’s Guide to Childbirth, 2003.

[5] “Chapter 1: The Powerful Mind/Body Connection” of Ina May Gaskin’s Ina May’s Guide to Childbirth, 2003.

[6] A narrative from the film Organic Birth: Birth is Natural! speaks to the frameshift it is to think about a contraction as something you must persevere through versus experience as a welcoming of your child into this world

[7] Lecture Notes: Technocratic Childbirth, Karen Walloch, September 11th, 2018.

[8] Monty Python’s The Meaning of Life: Miracle of Birth, 1983.

[9] Emphasis on who is doing the delivering of the baby. This is related to the development of the Friedman curve in the 1950s, which has since grossly defined what a normal length of labor is without extensive validation. The Friedman curve inspired the Dublin protocol of “active management,” a notion that still largely influences the medical model of birth today. “Chapter 1: Arranged Birth” in Pushed: The Painful Truth about Childbirth and Modern Maternity Care by Jennifer Block.

[10] Prior to the late 17th century, people gave birth on birthing stools, on their hands and knees, or in other generally upright positions. The lithotomy position was promoted by King Louis XIV as a way for him to watch women give birth. It’s unclear the influence his specific preference had on the widespread use of the lithotomy position today, yet it speaks to the nature of its use—for the observer, not the birthing person. The Evolution of Maternal Birthing Position, Lauren Dundes, 1987.

[11] Organic Birth: Birth is Natural! Adapted from Orgasmic Birth by Debra Pascali-Bonaro

[12] For example, Dona Juana, a popular Mayan midwife based much of her practice on ritualistic massage. Lecture Notes: Buscando la Forma, Karen Walloch, September 20th, 2018.

[13] Study Outline: The Right to “Choose” Technocratic Birth, Karen Walloch

[14] Lecture Notes: Consequences of Technocratic Birth, Karen Walloch, September 13th, 2018.

[15] Shadow of maternity refers to the “physical, emotional, and life-shaping consequences of pregnancy and childbirth in the 18th and 19th centuries.” Lecture Notes: The Shadow of Maternity, Karen Walloch, October 2nd, 2018.

[16] We might consider who is usually the one providing the alleviation… there are paternalistic underpinnings to this notion.

[17] Childbirth in Brazil: Challenging an Interventionist Paradigm, Eugine Declerq, Birth 42:1, 2015.

[18] This push for Obstetrics to be recognized as a surgical sub-specialty goes back to the rise of the Obstetrics field in the early 20th century as OBs started to push general practitioners out of the birth scene and came to monopolize the profession. Study Guide, The Transition to Hospital Birth: 1900-1950, Karen Walloch

[19] “Chapter 6: Authoritative Knowledge and Birth Territories in Contemporary Japan” in Childbirth and Authoritative Knowledge, Deborah Cordero Fiedler, 1997.

[20] It’s important to consider who will have “authoritative knowledge” (what knowledge has social status)  as defined by Bridgette Jordan in “Chapter 1: Authoritative Knowledge and Its Construction” in Childbirth and Authoritative Knowledge, 1997.

[21] Birthing centers are independent of health systems and are often run by midwives. They take on low risk pregnancies, and partner with hospitals to provide a continuum of care if necessary.

[22] I am often left thinking about what the purpose of a doctor’s appointment is. What I have come up with in many moments is that the doctor is focused on making sure I am not dying. Once they have proven that to me (and to themselves), they seem less interested (likely since they aren’t trained in this) in providing me knowledge to maintain my health, or thinking about optimizing my “as lived” experience of life (i.e. nutrition, sleep habits, exercise, etc.)

[23] Unassisted Childbirth is giving birth without the aid of doctors or midwives in your home. The birthing person dictates the rhythm and flow of birth. (Unassisted Chilbirth, Laura Kaplan Shanley  http://www.unassistedchildbirth.com)

[24] Pain to Power is a course taught by Debra Pascali-Bonaro, an International childbirth educator and creator of the film Orgasmic Birth (https://www.paintopowerchildbirth.com/)

This essay was adapted from an essay I wrote for Karen Walloch’s course on the history of childbirth in the Fall semester of 2018. I uncovered it as I am embarking on the journey of becoming a birth doula and knew it needed to be shared.

Math Musings: We all think we are imposters

I sit down at the small round table, rubbing the hand sanitizer I’ve just gotten into my hands. It’s 12:57 p.m. on Thursday, just before my regular volunteering shift in the children’s hospital and I’m wearing my red polo and name badge. I know I’m meeting a student today, but I don’t know how old they are or what we are about to work on—the three teachers in the children’s hospital serve students across all grades, making it almost impossible to prepare. The teacher comes in to join me at the table and tells me about the student. “Today I’m going to have you work with Liam*,” she says, “I’ve worked with him before, but I think working with you might be good for him. He needs to do his math, which he gets kind of anxious about.” I nod and she hands me a stack of paper triangles. I inspect them and realize they are flashcards with numbers in the corners—she’s handed me the stack of 9’s (9*2=18, 9*3=27, and so on…). “We’ve been working on his 9’s.”

Liam was a kind, brilliant kid who not only crushed his 9’s that day, but also mastered rounding to the thousands and hundreds place. I left the hospital that day confident in myself and proud of the confidence I could instill in him and his learning. A stark comparison to the tutoring session a few weeks earlier where I had felt like an imposter.

A past Thursday afternoon in the hospital classroom, I had been working with a high school student on pre-algebra. We had fun graphing polynomials to see how they shifted with different changes to the equations, but soon enough came to a new section where we encountered a problem that this student didn’t know how to solve. I pick up the whiteboard marker to demonstrate how I would multiply the polynomials together and then suggest he graph it to see what it looked like. He graphs the solution I came to next to the original problem (the equation without multiplying together the terms) and… the curves don’t match.

On the outside, I’m cool. On the inside I feel crazy: “What did I do wrong!! I have a Bachelor’s degree in engineering and I can’t even multiply these polynomials together!? Did I just teach this completely wrong?” I motion to the teacher who had just gotten back from another student’s room, “Does this look right to you? Do you remember the rules for distributing these terms?” She looked at me and said, “Nope, sorry!” She starts talking to the student so that I at least have a moment to do a quick google search. When I find an example online and compare it to mine, I realize I did it right. I just dropped a negative, and in that moment I’m heartbroken. Not for the dropped negative, but for the speed with which I believed I had done it wrong—for how immediate my distrust was.

This semester, I took a machine learning class, and who I walked into the room as on the first day of class was much the same person who immediately doubted them self that day at the hospital. I wasn’t sure what I had gotten myself into and I certainly was convinced that the other people in the room were better off than I was. And yet, the ground I have taken in this semester by putting myself into that (seemingly risky) environment has paid off! (Spoiler alert: I loved the class and am SUCH a nerd for machine learning and artificial intelligence).

What I’m learning, and sharing here in writing this, is that:

  1. I’m not alone in being intimidated or nervous by math sometimes. The more I open up to others about where I get stopped or confronted, the more connected I am to the universality of certain experience. Imposter syndrome is rampant.
  2. My willingness to step outside of my comfort zone is what brings me the most joy. It is also where I can make the biggest difference in contributing to others learning.
  3. I love math, and I had been unwilling to claim that before. Owning this unapologetically doesn’t even mean I need to be perfect at it!

So what can we do to inspire the next generation of STEM students + pioneers to discover their love of math and their confidence in themselves? Doesn’t everyone deserve the chance to love math!?!?

Now excuse me while I go help my husband as he’s studying to take a math placement exam… (no really, he is!)

*name changed for confidentiality

The 1 Question to Ask to Get Unstuck

I’ve always had a slight obsession with whiteboards. So much so that when I came back from the University Innovation Fellows Silicon Valley Meet-up in November of 2017, I started drawing up designs for a whiteboard wall (despite the fact that my husband and I occupied a 650 square-foot studio apartment). I settled on a large panel of whiteboard from the Menard’s that could be moved with me around the space and tucked away when necessary. A panel has carried me through many ideation and project planning sessions since.

I think my obsession with the whiteboards is, in part, an obsession with making. Particularly, the magic of turning nothing into something. A whiteboard is just that, a white board, until you put a pen to it. And once you have a pen (and an eraser), an infinite canvas awaits.

A key stage of the design thinking process, as used by the Stanford d.school, is prototyping. After you have immersed yourself in the experience of your user (empathize), defined your problem/challenge/need (define), and generated possible solutions (ideate), you begin building the ideas you’ve conceived. Prototyping is centered in a mindset of failing fast in order to learn quickly and is highly iterative. You might even introduce prototyping early in the design process, having people creating with their hands as they ideate with various office supply or crafting tools. Like this cart…  

The d.school’s design thinking process

At a recent meeting I left people pondering this question: what can you learn from the quick and dirty version? And really, this question is about prototyping. The value in this inquiry is getting to the real art form of prototyping–using each iteration as an opportunity to test an assumption, to put the idea into context and learn something from it.

So, what have you been procrastinating on building, making, or creating? Have you been hung up on doing it the “right” way or making sure it’s “good enough”? Stop that! Unleash your creativity and let yourself play. Discover what the quick and dirty version would be and go do it! Learn from that and do it again!

3 Finals Week Study Hacks from a Lifelong Learner

In honor of the brief respite of UW-Madison’s study day—the calm before the storm that is finals week—I’m putting pen-to-paper, so to speak, on some study hacks I have developed in my 5+ years in higher education studying engineering. My goal is to leave you with (at the very least) one thing you can implement this week to bring some confidence, ease, or clarity.

1. Get the big picture

Each finals week I start with the big picture. I sit down, usually with a blank piece of paper and a sharpie and a black pen (although this time I did it with a handy white board) and draw out a timeline. I start from today and draw it out to the end of finals or the day of my last exam or due date. I add in all the key deliverables for each of my classes to the timeline, and leave a list of “other” items at the bottom that don’t quite fit on the timeline clearly. I use this to house only hard deadlines, not the milestones I’ve made up for myself about writing or studying, just the hard stops and due dates.

Fall 2019 finals week overview/timeline–let’s do this!

Now you have your path. You know how long the week will be—it’s just a week. It’s finite. It’ll end, soon enough. You also now have a picture of the distribution of your work so you can start setting priorities for each day.

2. Put it in reality

Now that you have a sense of the big picture, you need to step down to the step-by-step, daily living of the larger timeline you drew out. How will the work actually get done? When will you do it? Where will you do it? Do you need to coordinate with anyone else?

You can do this in many ways, but start by moving backwards from the due date or final. For example, I’ve drawn out a timeline for a paper that is due next Wednesday. I know that if I’ve turned it in on Wednesday, I’ve probably done final edits the day of or day before (so let’s pick the day before to give some extra room), which means I wrote the final results section the day before that. I know already that I won’t work on this paper on Sunday since I am walking at graduation or tomorrow since I have an exam and presentation and a few meetings. So I keep stepping backward to what I would accomplish today.

My 705 research paper plan.

I might not do all this work for something that is less complex, say for an exam which I will just know that I need to block 3 hours to study for. Use your discretion and trust your gut, you know what works.

Now the real trick is to not leave it on the whiteboard or piece of paper, but to put it in reality next. Block off the time in your calendar and re-arrange the less urgent items around it. Text the people you need to coordinate with, and if you don’t hear back, but a note in your calendar to follow-up. Fool proof your plan in reality!

Other tips:

  • If you’re having trouble focusing, set 2 or 3 goals for the day, total. Stick to those and only those.
  • Start with the hardest thing, the thing you have been procrastinating on the longest. Even if it isn’t THE most important, having it complete may give you the boost you need to do the other things with alacrity.

3. First comes first: you

Now that you’ve done a lot of thinking about what you need to do (and when, and how, and with whom), give yourself the moment to think about what you want to do. Is there a way you can schedule in a bit of “me” time? Can you create breaks that are actual breaks that fulfill you, bring you joy, give you rest, move you forward on something else you’re working on? Put those in the calendar or on a list in front of you so that you can take them when you need.

A few examples of breaks I have taken:

  • A warm bath reading Ray Kurzweil’s book, How to Create a Mind.
  • Spending time with my pet rats and/or cats.
  • Perusing LinkedIn for interesting articles or new possible connections (or the chance to re-connect with someone I’ve known before). This can be an especially useful way to spend your time, paying off down the road in meaningful connections.
  • Simply switching gears to a different project—maybe the break I need from writing is just to look at a spreadsheet and do the mind-numbing task I can’t usually get myself to do. Putting those next to each other as I plan my day may be advantageous.
  • Going out to dinner with my family.
  • Seeing my therapist.
  • Cleaning the kitchen and listening to the news or my favorite podcast, 99 Percent Invisible.

I’ve been a student for what feels like forever and will be a student for what some people would call forever. If I’ve learned anything along the way, it’s that you won’t always remember the grade you got on that exam or paper, but you will remember the people you studied with, learned from—whose company you enjoyed—and who you got to be in the process.

Build those moments to reflect on what you have accomplished this semester and celebrate yourself and your friends/colleagues into your week as you tackle finals! Good luck!

3 Things to know about Human Factors Engineering: Starting with what the heck is it?

Most of the time when I tell people I’m studying Human Factors Engineering, I get a blank stare or an “oh, so you mean the human side of engineering!” I respond with “Kind of!” and launch into my elevator pitch on what Human Factors Engineering (HFE) is…

“It was formerly called Engineering Psychology,” I say, “It’s actually synonymous with the term ergonomics. We often only think about physical ergonomics—take for example that chair. Someone designed it, chose who fit in it, who didn’t fit in it, influencing how we interact with it, etc. We can also think about cognitive and social/organizational ergonomics as we design products, interfaces, systems, and even jobs.” Cue more confusion on the face of whomever unknowingly prompted my tangent.

Since sometimes us HFE folk have a hard time describing our field in a few sentences, I’ve decided to write this post covering 3 things you didn’t know about Human Factors Engineering (HFE). We will start, quite naturally, with answering the question “what the heck is HFE?”

Thing 1: What is HFE?

The International Ergonomics Association defines ergonomics (human factors) as follows:

Ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance.

Practitioners of ergonomics and ergonomists contribute to the design and evaluation of tasks, jobs, products, environments and systems in order to make them compatible with the needs, abilities and limitations of people.


Ergonomics helps harmonize things that interact with people in terms of people’s needs, abilities and limitations.


International Ergonomics Association, “What is Ergonomics?”

As the IEA definition clarifies, the nature of HFE is that it is multi-disciplinary and applied, leaning heavily on design. It pulls ideas from many domains to create actionable insights that impact people’s ability to do their best work, safely and joyfully.

In Designing for People: An Introduction to Human Factors Engineering, the authors (including UW Professor John Lee) say that HFE “aims to make technology work for people” along three dimensions: safety, performance, and satisfaction. The value placed on each of those dimensions may vary greatly, as you could imagine, depending on the application. For example, we may focus more significantly on safety when we design a plane than when we are designing a word processing software where performance or productivity is the focus.

This visual, taken from Designing for People , represents the way our priorities may shift depending on the domain or work we are applying HFE to (found on page 4)

However, in any of these cases, HFE must keep all three goals in mind to produce effective solutions.

Thing 2: How do people use HFE?

HFE is field of diverse methods and applications used to achieve the three goals discussed above: safety, performance and satisfaction. Tools in the HFE toolbox include heuristics, usability study and design, process and workflow mapping, participatory and user-centered design, contextual inquiry and qualitative research methods, FMEA and other error-reduction strategies, and many, many more.  

A central tenant of HFE is systems thinking, or approaching problems with a wide view and attention to interaction, iteration, and emergence. HFE never blames a person for their error, but rather looks at what “perfect storm” of system qualities allowed for errors to occur.

As such, you can imagine that HFE is both used to study systems after something went wrong (a product of poor system design) or intervene before error occurs by designing for optimal human-system interaction.

An Example


After a long day of work, I walk to my car. My phone alerts me that I need to stop at the pharmacy on my way home to pick up my prescription. I hop in my car and start driving home, and next thing I know I’m parked in my driveway. Dang it! I meant to stop for my prescription.

This seemingly mundane example is showcasing a really awesome and challenging thing about our brains. On one hand, isn’t it convenient that you don’t have to think really hard about your drive home? On the other, your ability to follow your usual path meant you made an error this time. You weren’t able to divert from that path.

HFE would look at this example and say, how can we design the system to support my intent to stop at the pharmacy? Maybe we can create an alarm that will sound when if I make the turn away (towards home) from the pharmacy. Or plan to pick up my prescription at a time where I’m not doing such an ingrained task. Or maybe if there was a post it note on the dashboard, I would have remembered!

Now just imagine we are talking about a task that a surgeon does every day. How can we support them to do the tasks (which might be similarly ingrained), while preventing errors that might be the difference between life or death for their patients? This is where HFE gets really interesting.

Thing 3: Why is HFE important?

And for any of you who are still wondering why HFE would matter to you or your field, here’s the quick two-bullet summary:

  • HFE concepts apply to everything you do and all the things you interact with (e.g. your screen time, how safe our cars are, job motivation)
  • Understanding HFE concepts allow you to align the world to produce what you intend through thoughtful re-design (e.g. reorganizing your phone to produce a result of less screen time, designing cars so that they are less distracting to the driver, creating jobs that are challenging and engaging to employees)

In Summary

HFE is a discipline with the power to create a world that works for everyone. Luckily, every field could stand to evaluate its workability and take a systems approach to re-designing and developing itself actually produce its intended outcomes.

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Thanks for reading this far! Stay tuned for the next article in my series: Why Engineers are Essential to the Future of Health Care

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Are you an HFE researcher or practitioner? How to you describe what you do? Comment below or tweet at me  to start a conversation.

Inventing a New Future: I’m a PhD Student!

Hanna tweeting "Big news disguised in a brief email--I'm going to get my PhD!!!" and a screen shot of the acceptance email.

In honor of my recent acceptance into UW – Madison’s Industrial and Systems Engineering Department’s Doctor of Philosophy program, I’m embarking on writing a series of articles on Human Factors Engineering and its applications. My intention with this series is to share with you:

  • What Human Factors Engineering (HFE) is
  • The many ways HFE influences the world around us
  • How HFE can be leveraged to create safety, productivity, and joy
  • How HFE is being used in specific contexts, particularly health care
  • And more…

So stay tuned for more content from my brain! For now, I will leave you with my vision for the future.

PhD Application Personal Statement

Hanna Barton | September 14th, 2019

The future is calling for new and innovative health service design and delivery structures. Since the Institute of Medicine’s (IOM) landmark reports, To Err is Human and Crossing the Quality Chasm, were published in 2000 and 2001 the field of Health Systems Engineering has been growing. So much so, that the National Academy of Engineers (NAE) has come together with the IOM in Building a Better Delivery System with a charge to engineers to apply their time-honored tools to the behemoth struggles we face in healthcare.

I would like to answer that call. There is no better work for me to do with my life than to develop systems and structures that provide people with optimal health: ones that really work for people, with no one left out. Continuing on from my Master’s degree program to conduct research and earn a PhD here at the University of Wisconsin – Madison is the next step to prepare me to make this difference.

I became an engineer because I saw that, while noble to pursue knowledge for its own sake, I am driven to integrate it to make change, to build and to design with it. Through my Biomedical Engineering coursework, I fell in love with the design process—the way people of varied backgrounds and expertise could come together to create something that hasn’t existed before but exactly what’s required. By iterative design experience, I saw firsthand the value that team members, including myself, brought when we applied new mindsets to engineering design, be they public health or gender and women’s studies viewpoints. 

During my accelerated Master’s program, I’ve had the chance to take a cross-sectional view of healthcare, completing courses in the law and business schools this past semester. The luckiest moment of them all may have come, though, in an Industrial and Systems Engineering course when Dr. Nicole Werner approached me about working in her lab for the summer. My experience working with Dr. Werner inspired me to broaden my perception of what could be accomplished in academia. I am drawn to Werner lab because it runs the full continuum from conducting qualitative research (visiting and interviewing people and distinguishing emerging concepts from the transcripts), to theorizing and publishing about those concepts, to conducting participatory design sessions and developing design recommendations for assistive technology, to ultimately building, implementing, and testing those technologies.

My intention is that my research as a PhD student will bring together many of my passions and talents—including my 1) fascination with design, design thinking, and participatory design work, 2) commitment to serving historically marginalized or under-served communities, 3) love for inter-disciplinary, collaborative work, 4) focus on global perspectives and implications and 5) excitement about seeing projects realized and implemented in the world.

There is so much meaningful work to be done in healthcare (and in health and well-being more broadly) that will require a distinct mindset. And while health care providers are essential to health and wellness, a new kind of healthcare workforce is warranted—one of collaborative effort between experts in policy, data science, clinical care, and human factors and systems engineering. Human Factors engineering is uniquely situated to inform the design and implementation of systems and technologies that holistically support people’s truest intentions—leaving people healthier, happier, more satisfied and productive.

9 Lessons Learned as a D1 Track + Field Athlete at Wisconsin

It’s May 24th, 2019 and the Sacramento sunshine is beating down. I take a swig of my energy drink, noticing the ache in my knees. I stomp my feet to feel my muscles flex under my red uniform. I’m ready. I’ve been preparing this whole season for this moment—what could be the last competition of my collegiate discus career. I enter the ring, a balance of amped up and calm, tight and relaxed, powerful but fluid. I center myself and my breathing. Here I am. This is my moment.

Not two months earlier I was terrified to meet this moment. To come face to face with the inevitability of the end of my career. I had spent the last 5 years (at least) fighting to not be seen as ‘just an athlete,’ but as soon as my last season started, I ached at the thought of losing this identity. It was debilitating and torturous. How was I to enjoy these moments or soak them up? It seemed absurd!

It was sometime in late April, after a few rough competitions, that it became obvious to me that throwing a discus now wasn’t just throwing a discus. It meant something. It was some measure of me. I was tormented by the thought that I would end my career mediocre. Over the course of conversations with a sports psychologist I started to own that. I started to uncover a power and ease again, exploring what I could be interested in besides those fears. There was no answer, of course. No clear-cut pathway to the confidence and peace of mind I was looking for, but there was a little opening for joy. A space to notice why I did any of this anyway.

The highlight of my career was a few weeks later. I woke up early to get to the store to buy my mom some flowers (it was Mother’s Day) before heading to the breakfast I could hardly eat. The last day of competition at the 2019 Big Ten Outdoor Track and Field Championships was here. The competition was messy—stalled by a broken net hoist and precarious solutioning. I went into my last throw in third place, knowing that no one could knock me out of it. Knowing that I had achieved the goal I had set to medal. The disc flew out of my hand well left of the sector lines (a foul throw), but it didn’t matter. I leapt onto my teammate with an energy I had never had and came crashing to my knees. Could it have actually happened? Was this real life? I stood on the medal stand with so much pride. I had done it.

Me with my parents and husband in Iowa City, IA after taking 3rd in discus at the 2019 Outdoor Big Ten Championships. Photo credits to my dad’s right arm.

Which brings us back to May 24th. Nothing left to lose. Nothing left to gain either, because it wasn’t about proving anything anymore. I enter the ring for my first throw, steady and determined, and throw the best throw of my career: 53.14 meters (174’ 4”). A throw about five feet shy of my season goal and 44 feet further than my best high school throw. I don’t qualify for the NCAA final round, but I celebrate a victory for myself. A victory in my spirit.

A photo of the board displaying my personal record throw of 53.14 meters or 174′ 4″ at the 2019 NCAA First Round in Sacramento. Photo credits to my husband, Mason.

I started my throwing career just 9 years earlier and, in high school, had no interest in throwing in college. I was baffled that anybody could possibly want to spend *that much* of their life on one specific movement. Volleyball? That made sense to me… there’s a communication aspect, so many distinct movements and motions… you could spend a lifetime perfecting that craft. Throwing? It’s one movement that lasts not even seconds! And it’s definitely not like you’d throw in college for the fame, fortune, or the chance to go pro (unless maybe you’re my teammate, Kelsey Card, but even then…).

I usually tell the story that I decided to throw in college because I had a number of knee injuries in high school. After a major surgery that took me out of my senior volleyball season, I was concerned that a few more years of volleyball would render my knees incapable of the life I dreamed of after sport. But if I am clear with myself and you (whoever you are reading this), I threw in college because it was a pocket of my life that grounded and yet challenged me. That at the end of the day, was mine, and only mine. I could see the fruits of my labor and I wouldn’t be allowed to stagnate. Contrary to my initial beliefs about investing an athletic career in Track and Field, I learned a lot about life.

As tribute to the people and University that invested in me, I thought I might summarize my top nine life lessons learned as a Badger student athlete here.

You’ll always think you have more to give.

And maybe that’s a good thing! Just don’t let it get in the way of celebrating life while it happens.

Trust your coach (they see what’s possible when you can’t).

Find someone who can see endless possibilities for your future. Prepare for your relentless thoughts that it’s not possible by choosing to trust their vision when you’re at your limits.

Don’t forget why you’re there anyway (you love it!).

When it’s not obvious why you’d put that much weight on the bar or show up on that day you wish you could just sleep in, put yourself in the ring on a beautiful spring day, the discus flying effortlessly from your hand. Allow yourself to feel that joy and bring it to the current moment. Much of life goes this way too… we lose sight of the vision and possibility we saw for ourselves in having started that job, relationship, or activity somewhere along the way. Restoring yourself to who you were when you stepped into that future brings the joy back.

Life is better with a friend.

It might seem easier or quicker to go it alone, but you miss out on the camaraderie and spirit of your teammates. The ones who will slap you on the shoulder and firmly remind you it’s “just a mindset” when you need a pick-me-up and have your back when it comes time for competition.

Me embracing my teammate, Banke, after my last competition (2019 NCAA First Round in Sacramento). Photo credits to UW Athletics.

Setbacks happen, it’s about who you get to be in the face of them.

Life never stops happening, does it? Injuries are a part of being an athlete. The thing is they are just circumstances. Circumstances “shmircumstances.” In reality, our circumstances don’t have anything to do with who we get to be in the face of them. Don’t we just love a good comeback story anyway?

You don’t have to feel good to throw far.

Mostly your feelings aren’t a great predictor of performance. Listening to and being dictated by them won’t get you where you really want to go in life. If your feelings didn’t run you, what could?

You are not your throws.

Nothing can measure you. Nothing out there in the world can tell you that you are enough. Isn’t that a relief? Seems like the next logical question is, if I didn’t have to go looking for some measure that I am enough, what could I be looking for in the world? Because… if you actually go looking for that, I bet you’ll find it.

Your mind matters.

One of the single most important services that Wisconsin offered me was an accessible, brilliant sports psychologist. It took me until my fifth year to utilize these services—maybe out of pride, maybe out of negligence—but I recommend them unabashedly. Your mental health matters. Take care of yourself and protect your space to do that.

Life’s messy and unpredictable.

Track and Field wouldn’t be a sport if everyone threw their best at every competition. Life is the same. Really, if you know how the future will go, you are limiting yourself.

I started writing this on the flight home from Sacramento in May. I’ve been struggling to finish it all summer, grappling with what it looks like to complete such a large portion of my life. The truth is I don’t have to go looking out there for something to tell me I am complete anymore. The victory is in knowing I am whole and complete exactly where I am. And when I am whole and complete, all that is left is gratitude.

Thank you, Wisconsin. Thank you, each individual person who helped me to succeed as a student athlete and as a human being. I’m honored to have worn the motion W on my chest and to have swayed to and sang Varsity in your company. I’ll always be a Badger.

Love, Hanna + On Wisconsin!

Why do I need a liberal arts education anyway?

The saying ‘knowledge is power’ is an old adage, that must transform into ‘critical thinking is power.’ Living in a day and age where anything you could want to learn is as close as a google search away, it becomes no longer a question of knowledge, but of understanding—of the way we view and interact with the world and the other people in it.

A liberal arts education seeks to expand our way of thinking about and understanding the world. It has its necessary components of learning concrete ‘knowledge,’ but where the true power of a liberal arts education is the opportunity to develop the ability to decipher fact from fiction, to acknowledge biases, to view life from another person’s eyes, and to collaborate across disciplines and backgrounds.

Inside of a commitment to ‘be the change you wish to see in the world,’ there is no room for the righteousness that is the human-trap of knowledge. We have to instead be open to being told we are wrong, that we have a skewed view, or that we may be missing the point. However, I don’t say that to mean we should give up on what we are committed to, it’s actually quite the opposite case. We have to be the courageous ones willing to put ourselves on the line for the things we care about.

As someone who has a liberal arts education with emphases on biomedical engineering and gender and women’s studies, it’s my job to put myself first into the intersection of these fields. Any fears I have yield to my conviction that the world needs the love and compassion I have to offer. Although, I’m not the first, nor the last to put myself into this arena. In this sense, it is silly to think that sitting back and waiting for someone to make the contribution or be the change I want to see in the world is a better plan of action. It is clear to me that the study of gender and women’s studies with no application to other fields is completely counter to the study of it at all. The concepts of sex and gender and sexuality can’t remain as academic definitions used only in feminist-based fields; they must be brought to historically sexist or divided fields. It’s in this melding of disciplines that we can make a difference for those who are historically left behind or disadvantaged.

An ethnic studies counseling psychology class I took in 2016 opened my eyes to all the ways my identity intersects—from the places I have privilege to the places I myself am disadvantaged. It gave me a chance to reflect on my identity in more ways than I had ever thought of it before—from my race, socioeconomic status, gender, sex, sexuality, education-level, and many more. More importantly, however, it gave me a chance to see where these intersect: where my status as a woman interacts with my male-dominated engineering education or where my whiteness affects the perspective I have on money. I had never had a place to see and acknowledge my biases and privilege so freely than in this class. By gaining an understanding of the perspective I naturally have on the world, I got that the world wasn’t necessarily that way or any one way at all. And if the world isn’t the one way I see it, I have more power to interact with people and see things from their perspective.

That is just one example of the contribution that I want to be in the world, but I see this all over my life. It’s in the kind of friend I am for people—the one that they can say anything to and be unconditionally accepted and loved—but mostly the one that stands for their greatness expressed in the world. It’s in the way I spend my time promoting innovation and entrepreneurship on campus through my networking and group work, but also in putting my ideas up for scrutiny by distinguished faculty and entrepreneurs. It’s in the way I am constantly looking for the connection and relation of one class’s concepts to another that is indicative of my well-rounded liberal arts education.

Without the support of gracious mentors on campus and a liberal arts perspective on education, I wouldn’t have developed into the critical thinking, passionate, and resilient change agent I am now. Through coursework, projects, and simple conversations, I have experienced the heartbreak of not achieving a goal and the wave of power and excitement that comes with finding a partner that is just as passionately invested in what I’m up to. The charge from Ghandi “be the change you wish to see in the world” is really the opportunity to play full out in your life, because why not?

“This is the true joy in life, the being used for a purpose recognized by yourself as a mighty one; the being a force of nature instead of a feverish clod of ailments and grievances complaining that the world will not devote itself to making you happy.

I am of the opinion that my life belongs to the whole community, and as long as I live it is a privilege to do for it whatever I can.

I want to be thoroughly used up when I die, for the harder I work the more I live. I rejoice in life for its own sake. Life is no “brief candle” for me. It is a sort of splendid torch which I have got hold of for the moment, and I want to make it burn as brightly as possible before handing it on to future generations.”

George Bernard shaw

As one of my favorite quotes by George Bernard Shaw goes, my life isn’t just for me, and isn’t just for my comfort. It is the opportunity of a lifetime; the opportunity to be the possibility I see the world as—one of freedom, fulfillment, connection, and love. The realization of this future is grounded on the education of the citizens of our world in what it means to be human, as well as the realization of the power of understanding the world in a broader sense and creating their unique purpose and role in it.

[This essay was adapted from a version I wrote in February of 2017]